Conveniently located to serve St. Louis, Missouri
As we age, the thin eyelid skin under our eye descends down due to the effects of gravity. This gravity affects the cheek and also causes “jowl” formation and deepening of the nasolabial fold. This is worsened by loss of volume, or deflation, of the face and cheek. As a result, the eyelid skin which is usually over the cheekbone elongates and descends below the cheekbone, causing dark circles and giving a tired appearance. Also, the muscles of the neck weaken and fat accumulates in the neck. This produces neck “bands”, fullness in the neck and excess skin. Glands in the neck droop and can cause bulging on the weak tissues. Finally, the brow descends and extra skin develops in the upper eyelid. People raise their eyebrows to compensate, causing deep lines and furrows on the forehead. Fortunately, there are several options to improve these features.
Dr. Cabbabe believes that the face should be treated harmoniously to maintain balance. During your consultation, the entire face including the forehead, brows, periorbital area, face and neck will be evaluated and recommendations will be provided to maximize your results. Patients in the 40’s may be surgical candidates for deep plane neck lifts. Most facelift surgery is otherwise started in the 50’s. By doing so, better results can be maintained over the lifetime versus starting in the 60’s or 70’s. Despite surgery, the face will continue to lose volume and excess skin will slowly accumulate based on the underlying quality of the skin. Prior sun damage and smoking contribute to accelerated aging. Fillers have a role beginning in the 40’s, but overuse can lead to facial imbalance, retained product and unpredictable surgical results.
Dr. Samer Cabbabe is regarded as one of the best plastic surgeons in St. Louis and the U.S. Dr. Cabbabe always cautions his patients to be wary of advertisements for “minimal recovery” type of facelifts because oftentimes the result is “minimal”. Similarly, there are many technology gimmicks that claim to tighten skin that are not only ineffective and expensive, but also damaging to future surgical options and results.
Dr. Cabbabe incorporates his experience with reconstructive and cosmetic surgery of the face to give patients the best results possible to meet their desires. He is also an expert in minimally invasive cosmetic surgery of the face and has published on these topics. His patients have a natural, refreshed look after surgery. His patients do not have “surprised” or “windswept” appearances because Dr. Cabbabe uses the newest and best techniques for his patients, not just stretching or pulling the skin back and removing the excess skin.
As an innovator in plastic surgery, Dr. Cabbabe is always on the cutting edge of techniques. His techniques in facelift surgery have evolved over the years to place more emphasis on the appearance of the eyes and mouth after facelift surgery. To maximize the aesthetic outcome, Dr. Cabbabe almost always recommends fat injections to restore volume around the eyes, mouth, and forehead, including the lips and chin. This is a subtle augmentation, not a “Hollywood” style augmentation. Future fillers are often still needed to maintain volume in the aging face.
Dr. Cabbabe has published on facial plastic surgery in the prestigious Journal of Plastic and Reconstructive Surgery:
Cabbabe S, Andrades P, Vasconez LO, “Lateral orbicularis oculi muscle plasty in conjunction with midface lifting for periorbital rejuvenation”, Plastic and Reconstructive Surgery, October 2009:124(4):1285-93
During your consultation, Dr. Cabbabe will carefully examine your entire face including the brow, upper and lower eyelids, face and neck. He will make recommendations in order to help you achieve your desired result while maintaining facial harmony. Some people who have early jowls but don’t need a full facelift may be a candidate for a midface/cheek lift which can be done in the office under local anesthesia. Dr. Cabbabe believes that the entire face should be in harmony and may recommend other procedures such as brow lift, upper blepharoplasty, lower blepharoplasty or neck lift to be done at the same time.
During this procedure, incisions are generally made on each side of the face around and extending as needed based on the the amount of excess skin. The skin and fat of the face and neck are separated to address each independently. The cheeks may be elevated/re-positioned in order to restore fullness to the cheekbones, improve the jowls, improve/shorten the lower eyelid skin and turn the corners of the mouth up. The deep tissues are tightened in order to improve the contour of the face and neck and give a long-lasting result, particularly in the neck. Partial gland removal may be done if necessary to prevent visible bulging in the neck after surgery. The skin is then re-draped and excess skin removed. No excessive pulling or stretching of the skin is needed to accomplish this, and this avoids an “operated” appearance. Fat is injected as needed into the forehead, around the eyes and mouth, and into the lips and chin. A droopy (witch’s) chin will also be addressed and lifted. A drain is frequently left in the neck to prevent blood or fluid from collecting.
Ideal Face-Lift Candidates
Patients who have loose skin around their faces and jowls are ideal candidates for a face-lift. The same goes for patients with a hollowness in areas like the cheeks or under the eyes. Additionally, if a patient has moderate to deep facial lines and wrinkles, they would be an excellent candidate for this facial-rejuvenation option.
Patients must be of age, must be in general good health, and must have realistic expectations. Patients who have a negative outlook would not be good candidates for this procedure.
Patients who are heavy smokers or drink too much alcohol would be advised to reduce or quit the habit altogether before the procedure. Smoking has a negative effect on the health of the skin tissues and can lead to a number of complications during healing.
This procedure is similar to a face-lift with the exception that the scars are generally minimized in terms of length to the front of the ear and sometimes slightly behind the ear if needed. The cheeks may not be re-elevated, fat injections are often incorporated.
Some type of neck lift is almost always incorporated to maintain the harmony of the face. This procedure will eliminate neck bands, provide an h3 jawline and a nice contour of the neck.
An incision is made under the chin and liposuction is done as needed in the neck. The weak muscles are tightened after the skin has been lifted. Partial gland removal may be done to optimize results. The skin is then re-draped and excess skin is removed behind the ears. Neck bands are eliminated as needed.
Preparing for Surgery
Dr. Cabbabe will ask that you refrain from taking any aspirin, Plavix, Coumadin, ibuprofen or any other type of blood thinner. He will also ensure that your blood pressure has been properly controlled if you have high blood pressure. On the morning of surgery, Dr. Cabbabe will precisely mark the planned incision and injection lines.
Before & After Gallery
View before-and-after pictures of real patients of Cabbabe Plastic Surgery
The procedure(s) can be 4-6 hours in length depending on how many additional procedures procedures are requested, such as the eyes and forehead. The procedure can done under local anesthesia with sedation or general anesthesia. Most surgeries are done in the operating room. Fine sutures are placed at the time of surgery which will be removed 5-7 days later. Drains are often placed for neck lifts. A face lift strap with neck compression will be placed at the time of surgery for 24-48 hours,
Your Facelift will be performed in a hospital or surgery center in St. Louis, MO.
Patients are able to go home after surgery, but some choose to stay overnight depending on the length of the procedure. Pain medication and antibiotics will be prescribed as needed as well as steroids. Bruising and swelling may be present for up to 2-3 weeks. Dr. Cabbabe will ask that you keep ice on the area immediately after surgery for the first 48 hours to decrease this. He will also ask you to keep your head elevated to decrease swelling and apply antibiotic ointment to the incision line. Eye drops may need to be placed if eyelid surgery was done to keep the eyes moist. The head and neck will be wrapped after surgery for 48 hours. A drain may be left in the neck for 1-3 days. Patients are able to shower within 48 hours after removing the bandages. Antibiotics ointment should be applied to all incisions, polysporin is preferred on the face and special ointment will be given for eyelids to prevent eye irritation.
How Much Does a Facelift Cost?
The total cost of a facelift will depend on several factors. The price will be affected by the extent of the cosmetic issues being addressed, the time required to perform the surgery, and anesthesia fees.
Possible complications include bleeding after surgery or hematoma, asymmetry, irregular contours, nerve injuries, reabsorption of injected fat or fat embolism. These could potentially require additional surgery. While rare, nerve injuries can affect facial muscles but generally improve over a few months.
Scheduling a consultation with Dr. Samer Cabbabe would be highly recommended for patients interested in a facelift in St. Louis. Contact us today to arrange your appointment.